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Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

A variety of terms, such as "antiepileptic," "anticonvulsant," and "antiseizure" have been historically applied to medications for the treatment of seizure disorders. Terminology is important because using terms that do not accurately reflect the action of specific treatments may result in a misunderstanding of their effects and inappropriate use. The present International League Against Epilepsy (ILAE) position paper used a Delphi approach to develop recommendations on English‐language terminology applicable to pharmacological agents currently approved for treating seizure disorders. There was consensus that these medications should be collectively named "antiseizure medications". This term accurately reflects their primarily symptomatic effect against seizures and reduces the possibility of health care practitioners, patients, or caregivers having undue expectations or an incorrect understanding of the real action of these medications. The term "antiseizure" to describe these agents does not exclude the possibility of beneficial effects on the course of the disease and comorbidities that result from the downstream effects of seizures, whenever these beneficial effects can be explained solely by the suppression of seizure activity. It is acknowledged that other treatments, mostly under development, can exert direct favorable actions on the underlying disease or its progression, by having "antiepileptogenic" or "disease‐modifying" effects. A more‐refined terminology to describe precisely these actions needs to be developed. [ABSTRACT FROM AUTHOR]

An editorial is presented on the release of a white paper by the International Federation of Dental Hygienists (IFDH), summarizing findings from 5 global surveys on oral health conducted between 2019 and 2023. Topics discussed include toothpaste and electric toothbrush recommendations, oral-systemic links, sustainable dentistry, and oral hygiene instruction practices, revealing gaps between evidence-based knowledge and clinical decision making among dental hygienists.

The purpose of this position paper by the South African Academy of Family Physicians (SAAFPs) is to inform decision making on human resources for health policy in South Africa and the placement of family physicians (FPs) in the district health system. National policies have been marred by misunderstanding of the roles and contribution of FPs; and there is unhelpful variability in how FPs are positioned in the health services between provinces. In the private sector, medical aid schemes have discriminated against FPs by failing to remunerate them as specialists and to recognise their scope of practice. [ABSTRACT FROM AUTHOR]

Introduction: Over the last decade, the emergence and spread of personalized medicine (PM) have defined a substantial revolution in healthcare. In principle, healthcare system sustainability is challenged by the investments required for research and development, as well as the adoption of PM techniques in routine clinical care. The "Integrating China in the International Consortium for Personalized Medicine" (IC2PerMed) EU-funded project aims to integrate China into the "International Consortium for Personalized Medicine" (ICPerMed). IC2PerMed aims to align the EU and China's research agendas in this field to enable a swift development of approaches in the EU and China with strong leverage upon EU-Chinese collaborations. Methods: Within this project, we first mapped relevant policies on PM in both the EU and China, and then we involved European and Chinese experts in PM in workshops and Delphi surveys in order to identify relevant priorities for the implementation of PM in sustainable healthcare. Results: As a result of this process, we identified nine overarching priorities, each addressing specific aspects of the sustainability of healthcare systems and PM implementation, with the main goal of supporting policymakers in integrating PM approaches in the EU and China. Discussion/conclusion: The implementation of PM in health systems is appealing in terms of improved accuracy in diagnostics, treatment, and prevention of disease, as well as reduction of the side effects resulting from inefficient use of drugs. Research, development, and implementation of needed techniques require time and resources that can slow the adoption of PM in healthcare systems. The nine priorities we identified address some of the most critical points, trying to lay the foundations for a comprehensive approach. [ABSTRACT FROM AUTHOR]

Aim: To describe the co‐designing process of an online support programme with and for informal carers of people with heart failure. Design: A co‐design process built on core concepts and ideas embedded in co‐design methodology. Data sources: Our co‐design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. Outcomes: The co‐design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. Conclusion: Co‐design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. Relevance to clinical practice: Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person‐centred care and provides a valuable learning opportunity for those involved. Furthermore, a co‐designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self‐care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. Reporting methods: Consolidated criteria for reporting qualitative research (COREQ). Patient or public contribution: Both informal carers and content creators were involved in developing the support programme. [ABSTRACT FROM AUTHOR]

The landmark 2016 Minimal Invasive Extracorporeal Technologies International Society (MiECTiS) position paper promoted the creation of a common language between cardiac surgeons, anesthesiologists and perfusionists which led to the development of a stable framework that paved the way for the advancement of minimal invasive perfusion and related technologies. The current expert consensus document offers an update in areas for which new evidence has emerged. In the light of published literature, modular minimal invasive extracorporeal circulation (MiECC) has been established as a safe and effective perfusion technique that increases biocompatibility and ultimately ensures perfusion safety in all adult cardiac surgical procedures, including re-operations, aortic arch and emergency surgery. Moreover, it was recognized that incorporation of MiECC strategies advances minimal invasive cardiac surgery (MICS) by combining reduced surgical trauma with minimal physiologic derangements. Minimal Invasive Extracorporeal Technologies International Society considers MiECC as a physiologically-based multidisciplinary strategy for performing cardiac surgery that is associated with significant evidence-based clinical benefit that has accrued over the years. Widespread adoption of this technology is thus strongly advocated to obtain additional healthcare benefit while advancing patient care. [ABSTRACT FROM AUTHOR]

I n the context of an adequate health care organization, the figure of the neurologist as an emergency operator (in the emergency room—ER—and/or in a dedicated outpatient clinic) is crucial for an effective functional connection with the territory (and therefore with general practitioners), a reduction in inappropriate ER accesses, specific diagnostic and therapeutic approaches to neurological emergencies in the ER and a reduction in nonspecific or even unnecessary instrumental investigations. In this position paper of the Italian Association of Emergency Neurology (ANEU: Associazione Neurologia dell'Emergenza Urgenza), these issues are addressed, and two important organizational solutions are proposed: The Neuro Fast Track, as an outpatient organization approach strongly linked to general practitioners and non-neurological specialists and dedicated to cases with deferrable urgency (to be assessed within 72 h) The identification of an emergency neurologist, who is engaged in ER assessments as a consultant and involved in the management of the semi-intensive care unit of the emergency neurology and the stroke unit according to an appropriate rotation, as well as in consultations for patients with neurological emergencies in inpatient wards The possibility of computerizing the screening of patients with deferrable urgency in the Neuro Fast Track is described. A dedicated app represents an important tool that can facilitate the identification of patients for whom deferred assessment is appropriate, the scheduling of neurological examinations and reductions in the booking time through a more rapid approach to specialist assessment and subsequent investigations. [ABSTRACT FROM AUTHOR]

Perioperative nurses must provide culturally competent care to all surgical patients, and understanding gender identity and gender diversity may be the first step to creating an inclusive perioperative practice for transgender and gender diverse patients. In the nurse--patient relationship, limited exposure to and knowledge of diverse populations may negatively affect the health of this important demographic. When nurses are unaware of how care can be affected by explicit (conscious) or implicit (unconscious) bias, they may use transphobic stereotyping behaviours or act with microaggressions, like using excessive protective attire. Such care may invalidate gender identity and impede trust. In contrast, nurses practising gender-affirming care validate the patient's gender identity and life experiences, which supports autonomy and creates trust. The aim of this paper is to provide perioperative nurses with a deeper understanding of factors that may affect gender diverse patient's perioperative outcomes. In addition, understanding the social determinants of health affecting this demographic may result in better health outcomes. As such, the holistic care of the transgender and gender diverse patient is the optimal goal, with clinicians employing a non-judgemental, sensitive and compassionate attitude. [ABSTRACT FROM AUTHOR]

The Healthcare Nutrition Council (HNC) represents manufacturers of enteral nutrition formulas and oral nutrition supplements, including those categorized as medical foods and parenteral nutrition. HNC member companies, Abbott's Nutrition Division, Nestlé Health Science, and Nutricia North America, a subsidiary of Danone S.A., manufacture a majority of the medical foods consumed in the United States. HNC is proposing a modernized interpretation of the medical food framework to reflect the evolution of nutrition science and health care. The medical food category was first defined in 1988 as part of the Orphan Drug Act. Since then, the scientific community's understanding of nutrition and the role it can play in disease management has progressed. HNC believes that a patient-centric approach is needed to foster research and innovation and to position medical foods as a viable solution in the dietary management of disease. HNC proposes that distinctive nutritional requirements refer to the clinical need for a specific nutritional intake (compared with the intake of healthy populations), which may exist by reason of abnormal physiologic manifestation or physical impairment associated with a disease or condition. The dietary management of these diseases and conditions results in clinically meaningful improvements, including but not limited to nutritional status, health outcomes, or quality of life. HNC believes that abnormal physiologic manifestation or physical impairment would include a limited, impaired, or disturbed capacity to ingest, digest, absorb, metabolize, or excrete ordinary food or certain nutrients or metabolites or other medically determined requirements for nutrients or other food substances of biological value. HNC recommends our position be considered as we build consensus across the industry. We request that the Food and Drug Administration modify and codify the current definition to reflect this. Patients and the health care system will benefit from a strong regulatory interpretation of the medical foods framework. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness (e.g. psychosis, bipolar disorder) experience poor oral health compared to the general population as shown by more decayed, missing and filled teeth and a higher prevalence of periodontal disease. Attending dental services allows treatment of oral health problems and support for prevention. However, people with severe mental illness face multiple barriers to attending routine dental appointments and often struggle to access care. Link work interventions use non-clinical support staff to afford vulnerable populations the capacity, opportunity, and motivation to navigate use of services. The authors have co-developed with service users a link work intervention for supporting people with severe mental illness to access routine dental appointments. The Mouth Matters in Mental Health Study aims to explore the feasibility and acceptability of this intervention within the context of a feasibility randomised controlled trial (RCT) measuring outcomes related to the recruitment of participants, completion of assessments, and adherence to the intervention. The trial will closely monitor the safety of the intervention and trial procedures. Methods: A feasibility RCT with 1:1 allocation to two arms: treatment as usual (control) or treatment as usual plus a link work intervention (treatment). The intervention consists of six sessions with a link worker over 9 months. Participants will be adults with severe mental illness receiving clinical input from secondary care mental health service and who have not attended a planned dental appointment in the past 3 years. Assessments will take place at baseline and after 9 months. The target recruitment total is 84 participants from across three NHS Trusts. A subset of participants and key stakeholders will complete qualitative interviews to explore the acceptability of the intervention and trial procedures. Discussion: The link work intervention aims to improve dental access and reduce oral health inequalities in people with severe mental illness. There is a dearth of research relating to interventions that attempt to improve oral health outcomes in people with mental illness and the collected feasibility data will offer insights into this important area. Trial registration: The trial was preregistered on ISRCTN (ISRCTN13650779) and ClinicalTrials.gov (NCT05545228). [ABSTRACT FROM AUTHOR]

Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning. [ABSTRACT FROM AUTHOR]

Keeping up with the latest developments in the point-of-care ultrasound (POCUS) literature is challenging, as with any area of medicine. Our group of POCUS experts has selected 10 influential papers from the past 12 months and provided a short summary of each. We hope to provide emergency physicians, intensivists, and other acute care providers with a succinct update concerning some key areas of ultrasound interest. [ABSTRACT FROM AUTHOR]

The European Commission Horizon 2020 project—PreventIT—evaluated two approaches to delivering Lifestyle-Integrated Functional Exercise (LiFE) programs for maintaining older adults' physical function: the paper-based adapted LiFE and mobile health device delivered enhanced LiFE. A self-reported method was used to measure users' monthly adherence over 12 months. This analysis aimed to explore young seniors' adherence patterns between enhanced LiFE and adapted LiFE groups. Results showed that adherence level decreased with time in both groups. The enhanced LiFE group had slightly higher adherence than the adapted LiFE group during most of the 12 months. However, the overall adherence levels were not significantly different during either intervention or follow-up periods. Monthly self-reported adherence measurement can help to understand users' adherence comprehensively. The comparable adherence levels between both groups indicate mobile health could be an alternative to delivering home-based physical activity for young seniors. However, this feasibility study was not powered to detect differences between groups. [ABSTRACT FROM AUTHOR]

In people with bone and soft tissue injuries of the wrist, hand and/or fingers, do feedback-guided exercises performed on a tablet touchscreen hasten return to work, reduce healthcare usage and improve clinical recovery more than a home exercise program prescribed on paper? Randomised, parallel-group trial with concealed allocation, assessor blinding and intention-to-treat analysis. Seventy-four workers with limited functional ability due to bone and soft tissue injuries of the wrist, hand and/or fingers. Participants in the experimental and control groups received the same in-patient physiotherapy and occupational therapy. Participants in the experimental group received a home exercise program using the ReHand tablet application, which guides exercises performed on a tablet touchscreen with feedback, monitoring and progression. Participants in the control group were prescribed an evidence-based home exercise program on paper. The primary outcome was the time taken to return to work. Secondary outcomes included: healthcare usage (number of clinical appointments); and functional ability, pain intensity, and grip and pinch strength 2 and 4 weeks after randomisation. Compared with the control group, the experimental group: returned to work sooner (MD –18 days, 95% CI –33 to –3); required fewer physiotherapy sessions (MD –7.4, 95% CI –13.1 to –1.6), rehabilitation consultations (MD –1.9, 95% CI –3.6 to 0.3) and plastic surgery consultations (MD –3.6, 95% CI –6.3 to –0.9); and had better short-term recovery of functional ability and pinch strength. In people with bone and soft-tissue injuries of the wrist, hand and/or fingers, prescribing a feedback-guided home exercise program using a tablet-based application instead of a conventional program on paper hastened return to work and improved the short-term recovery of functional ability and pinch strength, while reducing the number of required healthcare appointments. ACTRN12619000344190 [ABSTRACT FROM AUTHOR]

The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare. TR integrates therapy-recovery-assistance, with continuity of treatments, aimed at neurological and psychological recovery, involving the patient in a family environment, with an active role also of the caregivers. This leads to reduced healthcare costs and improves the continuity of specialist care, as well as showing efficacy for the treatment of cognitive disorders, and leading to advantages for patients and their families, such as avoiding travel, reducing associated costs, improving the frequency, continuity, and comfort of performing the rehabilitation in its own spaces, times and arrangements. The aim of this consensus paper is to investigate the current evidence on the use and effectiveness of TR in the cognitive field, trying to also suggest some recommendations and future perspectives. To the best of our knowledge, this is the first consensus paper among multiple expert researchers that comprehensively examines TR in different neurological diseases. Our results supported the efficacy and feasibility of TR with good adherence and no adverse events among patients. Our consensus summarizes the current evidence for the application of cognitive TR in neurological populations, highlighting the potential of this tool, but also the limitations that need to be explored further. [ABSTRACT FROM AUTHOR]

The article discusses the positive pain reduction outcomes of a personalized care pathway for chronic knee pain post-total knee replacement.

Purpose: This paper aims to outline the initial pilot use of the client complexity matrix (CCM), an outcome measure developed for an NHS Adult Intellectual Disabilities Intensive Support Team (IST) in the West Midlands of England. Design/methodology/approach: A mixed method approach was used to report the results and evaluate the use of the CCM within this IST. The CCM was trialled for six months between January 2022 and June 2022. CCM scores pre and post IST intervention were analysed via t-test, and qualitative feedback from clinicians is detailed. Findings: Analysis suggests the CCM captures service success showing a significant decrease in complexity and risk post-intervention. Qualitative comments from clinicians were generally positive; however, there were requested changes regarding specific presentations, use of labels/language and for a digital version. Research limitations/implications: The tool is not co-constructed with the client. Because of this IST's caseload, the sample size was small. Only one clinician was asked to complete the CCM pre and post intervention. Future use of the measure will encourage two clinicians to complete the measure to evidence its inter-rater reliability. Each client's specific presentation was not explicitly analysed here. Practical implications: The CCM will be updated using the feedback from clinicians and from the peer review process. Research that examines the generalisability of this measure to other IST services would be beneficial. Originality/value: The CCM appears to fill a gap in outcome measurements for this IST service which looks at breadth and depth of client complexity and risk. [ABSTRACT FROM AUTHOR]

This paper explores the potential for a system to be a co-author on an academic paper based on the criteria proposed by the International Committee of Medical Journal Editors (ICMJE). We used a third generation generative pretrained transformer (GPT-3) to write a review paper on the topic of its choice: The Effects of Sleep Deprivation on Cognitive Function. The system was asked to fulfill the four main criteria for co-authorship as recommended by ICMJE, which includes contributions to the conception or design of the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; and agreement to be accountable for all aspects of the work. Our results showed that the system was able to fulfill the criteria, with significant difficulties with accurate and reliable referencing. We also explored the ethical implications of using AI systems for research and found that it is important to take a cautious approach when considering its use for scientific authorship. This case study provides a methodology for further investigations into the possibilities and limitations of automated writing. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide a response to the previously published paper on "Gerontocracy". Design/methodology/approach: This paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper. Findings: This paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society. Originality/value: Engaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic. [ABSTRACT FROM AUTHOR]

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020–2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19–20th August 2021). [ABSTRACT FROM AUTHOR]

Background: Study participants and patients often perceive (long) questionnaires as burdensome. In addition, paper-based questionnaires are prone to errors such as (unintentionally) skipping questions or filling in a wrong type of answer. Such errors can be prevented with the emergence of mobile questionnaire apps. Objective: This study aimed to validate an innovative way to measure the quality of life using a mobile app based on the EQ-5D-5L questionnaire. This validation study compared the EQ-5D-5L questionnaire requested by a mobile app with the gold standard paper-based version of the EQ-5D-5L. Methods: This was a randomized, crossover, and open study. The main criteria for participation were participants should be aged =18 years, healthy at their own discretion, in possession of a smartphone with at least Android version 4.1 or higher or iOS version 9 or higher, digitally skilled in downloading the mobile app, and able to read and answer questionnaires in Dutch. Participants were recruited by a market research company that divided them into 2 groups balanced for age, gender, and education. Each participant received a digital version of the EQ-5D-5L questionnaire via a mobile app and the EQ-5D-5L paper-based questionnaire by postal mail. In the mobile app, participants received, for 5 consecutive days, 1 question in the morning and 1 question in the afternoon; as such, all questions were asked twice (at time point 1 [App T1] and time point 2 [App T2]). The primary outcomes were the correlations between the answers (scores) of each EQ-5D-5L question answered via the mobile app compared with the paper-based questionnaire to assess convergent validity. Results: A total of 255 participants (healthy at their own discretion), 117 (45.9%) men and 138 (54.1%) women in the age range of 18 to 64 years, completed the study. To ensure randomization, the measured demographics were checked and compared between groups. To compare the results of the electronic and paper-based questionnaires, polychoric correlation analysis was performed. All questions showed a high correlation (0.64-0.92; P<.001) between the paper-based and the mobile app-based questions at App T1 and App T2. The scores and their variance remained similar over the questionnaires, indicating no clear difference in the answer tendency. In addition, the correlation between the 2 app-based questionnaires was high (>0.73; P<.001), illustrating a high test-retest reliability, indicating it to be a reliable replacement for the paper-based questionnaire. Conclusions: This study indicates that the mobile app is a valid tool for measuring the quality of life and is as reliable as the paper-based version of the EQ-5D-5L, while reducing the response burden. [ABSTRACT FROM AUTHOR]

The American College of Physicians (ACP) has a long-standing commitment to improving the health of all Americans and opposes any form of discrimination in the delivery of health care services. ACP is committed to working toward fully understanding and supporting the unique needs of the incarcerated population and eliminating health disparities for these persons. In this position paper, ACP offers recommendations to policymakers and administrators to improve the health and well-being of persons incarcerated in adult correctional facilities. [ABSTRACT FROM AUTHOR]

These 12 factors include: insufficient/incorrect patient education, insufficient/incorrect patient assessment, lack of consultation, insufficient/incorrect OTC product recommendation, discontinued medications, improper storage, expired medications, incorrect dosing (subtherapeutic/overdose), missing medications, drug-drug interactions/adverse drug reactions, therapeutic duplication, and inappropriate treatment duration. [Extracted from the article]

Background: Among the various components of disaster management during unexpected accidents, health care systems, especially hospitals, play the most important role in providing primary care services in the initial phase of the disaster. Health services in natural and humanmade disasters are the main cause of human survival. Accidents and disasters always have a significant impact on the safety, general health, and welfare of the affected population. Materials and Methods: In this paper, by collecting relevant data and their analyses in SPSS, we reviewed the response of the headquarters of the operation command of Alborz University of Medical Sciences to the Kermanshah earthquake in November 2017. Results: According to the obtained results, 25-27 years old and 80 years old groups had the highest number of casualties to receive relief services. Based on the results of the analysis in SPSS, the number of injured men who received health care services was higher than women (38 men vs. 37 women). Madani Hospital admitted the highest number of victims by accepting 54 (72%) injured people. Based on our analysis, multiple trauma had the highest prevalence (24%) among injured people, then trauma to the foot (9%), followed by the trauma of the lower back and hand fractures (6.8%). Of the total 75 injured people transferred to the hospital, 39 (52%) underwent the operation. One case was sent to a hospital in Tehran Province, and 7 (9%) casualties were settled temporarily. There was a case of amputation. One patient was re-hospitalized. Finally, 4 (5%) of the injured people left the hospital. Conclusion: Regarding the services provided, it can be acknowledged that the headquarters of the Crisis Operation of the Alborz University of Medical Sciences (in spite of its new establishment) had an excellent performance regarding the type and amount of the services provided to the injured people in the field of risk management of accidents/disasters in Kermanshah earthquake in November 2017. Some of the positive and essential measures of the headquarters of crisis operation command were planning operations; triage at the airport; transfer of the injured people; coordination with the hospitals; declaration of yellow status to all medical centers; use of the full capacities of the Medical Sciences University; assignment of beds and the issue of surge capacity of health centers; communication with organizations, centers, and hospitals affiliated to Alborz University of Medical Sciences. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to provide discourse regarding awareness of institutional racism, from a non-Indigenous, Australian nursing student's perspective. The discussion has a focus on the presence of institutional racism in the Australian healthcare system, its impact on the health of First Nation Peoples and a commitment to ensuring culturally safe practice. It will be argued that institutional racism is pervasive in healthcare as a consequence of three factors: exclusion of First Nations Peoples from governance roles, inherent racism impacting on socio-cultural treatment bias, and institutional racism influencing key relationships in healthcare delivery. [ABSTRACT FROM AUTHOR]

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The article focuses on children who have survived cancer, particularly those treated with chemotherapy and/or radiotherapy, have a higher risk of adverse cardiac events later on, a pan-European study has found. Topics include the investigators has assessed the cumulative incidence of symptomatic cardiac ischaemia in childhood cancer survivors, and the patients diagnosed with cancer in childhood, between 1940-2009, from seven European countries including the Great Britain.

While we have the tools to achieve this goal, the persistent barriers to healthcare services experienced by too many individuals will need to be addressed to make significant progress and improve the health and quality of life of all people with human immunodeficiency virus (HIV). The necessary structural changes require actions by federal, state, and local policymakers and range from ensuring universal access to healthcare services to optimizing care delivery to ensuring a robust and diverse infectious diseases and HIV workforce. In this article, we outlines 10 key principles for policy reforms that, if advanced, would make ending the HIV epidemic in the United States possible and could have much more far-reaching effects in improving the health of our nation. [ABSTRACT FROM AUTHOR]

Background: Primary care practices are responding to calls to incorporate patients' social risk factors, such as housing, food, and economic insecurity, into clinical care. Healthcare likely relies on the expertise and resources of community-based organizations to improve patients' social conditions, yet little is known about the referral process.Objective: To characterize referrals to community-based organizations by primary care practices.Design: Qualitative study using semi-structured interviews with healthcare administrators responsible for social care efforts in their organization.Participants: Administrators at 50 diverse US healthcare organizations with efforts to address patients' social risks.Main Measures: Approaches used in primary care to implement social needs referral to community-based organizations.Results: Interviewed administrators reported that social needs referrals were an essential element in their social care activities. Administrators described the ideal referral programs as placing limited burden on care teams, providing patients with customized referrals, and facilitating closed-loop referrals. We identified three key challenges organizations experience when trying to implement the ideal referrals program: (1) developing and maintaining resources lists; (2) aligning referrals with patient needs; and (3) measuring the efficacy of referrals. Collectively, these challenges led to organizations relying on staff to manually develop and update resource lists and, in most cases, provide patients with generic referrals. Administrators not only hoped that referral platforms may help overcome some of these barriers, but also reported implementation challenges with platforms including inconsistent buy-in and use across staff; integration with electronic health records; management and prioritization of resources; and alignment with other organizations in their market.Conclusion and Relevance: Referrals to community-based organizations were used in primary care to improve patients' social conditions, but despite strong motivations, interviewees reported challenges providing tailored and up-to-date information to patients. [ABSTRACT FROM AUTHOR]

Aim: To describe and discuss clinical strategies for nurses working in partnership with substitute decision‐makers for people living with advanced dementia. Background: By providing person‐centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision‐makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision‐makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision‐makers. Design: In this discursive paper, an innovative framework for working in partnership with substitute decision‐makers is proposed. Method: Evidence‐based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion: To deal with complexities and reduce stress for substitute decision‐makers, an innovative Nurse–Substitute Decision‐Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision‐makers are discussed. Relevance to Clinical Practice: In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision‐makers in areas that are known to cause complexity and stress to them. The Nurse–Substitute Decision‐Maker Partnership Framework has been designed to improve nurse–substitute decision‐maker partnerships and reduce the stress experienced by substitute decision‐makers as they work through the complexities associated with advanced dementia. [ABSTRACT FROM AUTHOR]

Radiology as a specialty has been enormously successful since its beginnings, moving over time from an adjunct to clinical decision-making to a crucial component of multidisciplinary patient care. However, this increased centrality of radiology and reliance on our services carries within it dangers, prominent among them being the danger of our being viewed as deliverers of a commodity, and the risk of our becoming overwhelmed by increasing workload, unable to interact sufficiently with patients and referrers due to pressure of work. With this White Paper, the Board of Directors of the European Society of Radiology (ESR) seeks to briefly explain the position of the radiologist in the modern healthcare environment, considering our duties and contributions as doctors, protectors, communicators, innovators, scientists and teachers. This statement is intended to serve as a summary of the breadth of our responsibilities and roles, and to assist radiologists in countering misunderstanding of who we are and what we do. [ABSTRACT FROM AUTHOR]

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system. [ABSTRACT FROM AUTHOR]

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process. Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training. Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine. Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice. Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies. [ABSTRACT FROM AUTHOR]

The article presents the discussion on COVID-19 pandemic highlighting the contributions critical care. Topics include intensive care units (ICUs) around the world suddenly inundated with patients who were critically ill from an unknown virus, along with all the other patients needing critical care services; and warrants consideration of energy, clinical supplies, pharmaceuticals, technical equipment and physical facilities.

Artificial intelligence (AI) has made tremendous advances in recent years and will presumably have a major impact in health care. These advancements are expected to affect different aspects of clinical medicine and lead to improvement of delivered care but also optimization of available resources. As a modern specialty that extensively relies on imaging, interventional radiology (IR) is primed to be on the forefront of this development. This is especially relevant since IR is a highly advanced specialty that heavily relies on technology and thus is naturally susceptible to disruption by new technological developments. Disruption always means opportunity and interventionalists must therefore understand AI and be a central part of decision-making when such systems are developed, trained, and implemented. Furthermore, interventional radiologist must not only embrace but lead the change that AI technology will allow. The CIRSE position paper discusses the status quo as well as current developments and challenges. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that students who are engaged in learning tasks and make errors before receiving instruction on how to complete them, achieve better learning outcomes than students who first receive instruction and then complete the learning activities with the aim of avoiding errors. Although simulation literature often refers to errors as learning opportunities, to date, there is limited understanding of how pedagogical approaches that promote learning from errors can guide the design of simulation-based learning in healthcare education. To (a) present the Learning from Errors conceptual model; and (b) provide an example of how educators can use this model. The Learning from Errors model is drawn from critical elements of two pedagogical approaches, productive failure and error management training and pedagogical features of high-quality healthcare simulations. We describe the Learning from Errors model, which emphasises the need for adopting pedagogical methods that explicitly use errors as learning opportunities and ultimately inform simulation design. We then illustrate the application of this model to a simulation example. The model includes the following elements: i) normalisation of errors, ii) challenging simulation scenarios, iii) self-directed learning, iv) collaborative teamwork and v) comparison with best practice. This discussion paper presents the Learning from Errors conceptual model, an evidence-based approach that can assist educators in the design of simulations that embrace errors as a catalyst for learning. [ABSTRACT FROM AUTHOR]

Aim: To present the first iteration of the caring life‐course theory. Background: Despite requiring care from birth to death, a person's universal or fundamental care needs and the subsequent care provision, either by self or others, has yet to be presented within a life‐course perspective. Accurately describing the care people require across their lifespan enables us to identify who, what type, how and where this care should be provided. This novel perspective can help to legitimise a person's care needs and the support they require from wider care systems and contexts. Design: Discussion paper outlines theory development. We adopted an inductive approach to theory development, drawing upon existing literature and the team's diverse experiences. Our theoretical insights were refined through a series of collaborative meetings to define the theory's constructs, until theoretical saturation was reached. Discussion: Fourteen constructs are identified as essential to the theory. We propose it is possible, using these constructs, to generate caring life‐course trajectories and predict divergences in these trajectories. The novel contribution of the theory is the interplay between understanding a person's care needs and provision within the context of their lifespan and personal histories, termed their care biography, and understanding a person's care needs and provision at specific points in time within a given care network and socio‐political context. Impact for Nursing: The caring life‐course theory can provide a roadmap to inform nursing and other care industry sectors, providing opportunities to integrate and deliver care from the perspective of the person and their care history, trajectories and networks, with those of professional care teams. It can help to shape health, social and economic policy and involve individuals, families and communities in more constructive ways of talking about the importance of care for improved quality of life and healthy societies. [ABSTRACT FROM AUTHOR]

All primary care clinicians should signpost patients who are overweight or obese to weight management programmes - either directly commissioned or commercial groups. MEDICAL EDUCATION WITH RELEVANCE TO PRIMARY CARE The winner of category 3 (Medical Education with Relevance to Primary Care) was a "realist review" that attempts to produce one or more theories to explain particular phenomena. The Research Paper of the Year (RPY), awarded by the Royal College of General Practitioners (RCGP), gives recognition to an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care. [Extracted from the article]

The home care workforce provides essential support for older people with dementia to live a life of fulfillment. " Enabling Choices," an evidence-informed conversation tool, aims to negotiate risk around everyday activities between home care workers, people with dementia and their informal carers. This paper describes tool conversion into electronic format and preparation for implementation throughout a large Australian health and aged care service provider, utilizing the Implementation Framework for Aged Care (IFAC). Using codesign principles, the tool was converted from paper-based to electronic format involving frontline, operational and Information Management Services staff, and people with dementia/carers. Focus groups and interviews identified tool acceptability, feasibility, and appropriateness. For implementation preparation, the wider socio-cultural-political context was mapped, and key questions of the IFAC addressed. Environment, workflow, and training requirements were determined, and strategies for behavior change ascertained. Numerous opportunities and challenges exist for the widespread upscale of an evidence-informed tool into practice. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) has the potential to completely transform healthcare by allowing medical professionals to remotely monitor patients, gather data on their activity and health in real-time, and create more efficient treatment regimens. IoT technologies have the potential to save healthcare expenditures while also enhancing patient involvement and improving patient outcomes. However, the adoption of IoMT has been slow, and To ensure that the advantages of IoT are realised while reducing the hazards connected with its use, a number of hurdles must be overcome. The purpose of this research paper is to examine the current state of IoT implementation in healthcare, identify the benefits and challenges of IoMT, and explore the future implications of IoMT. The study starts off with a survey of the literature that has already been written on the use of IoT technology in healthcare, highlighting both the potential advantages and difficulties of doing so. The paper then presents the results of a survey of healthcare providers on the use of IoT technologies in healthcare, providing insights into the current state of IoT implementation in healthcare and the challenges that must be addressed to facilitate its adoption. [ABSTRACT FROM AUTHOR]

Sexual and gender-based violence (SGBV) is a leading cause of physical, emotional, and psychosocial problems around the world, with many countries in East Africa having rates above the global average. Despite the high prevalence in the region, service provision for post-SGBV care is often poorly funded, difficult to access, or simply nonexistent. This review reports the findings of a scoping review of literature from East Africa. The goals of this research were to evaluate existing service provision practices throughout the region, understand how provider bias may affect service provision, and compare existing practices to national policies and internationally agreed human rights treaties. This review identified 54 academic papers and reports through a search of electronic databases and grey literature sources, and four main themes emerged: (1) current models of service provision are inadequate to address the medical and psychosocial needs of survivors; (2) countries are not providing sufficient funding for services; (3) further research is needed into how to incorporate SGBV care into existing health systems and align with international human rights treaties; and (4) there is limited research in many countries in East Africa. The findings are likely to be of use to policy makers, nongovernmental organizations, and service providers working in the medical, legal, and justice systems. [ABSTRACT FROM AUTHOR]

Open Dialogue is a need‐adapted approach to mental health care that was originally developed in Finland. Like other need‐adapted approaches, Open Dialogue aims to meet consumer's needs and promote collaborative person‐centred dialogue to support recovery. Need‐adapted mental health care is distinguished by flexibility and responsiveness. Fidelity, defined from an implementation science perspective as the delivery of distinctive interventions in a high quality and effective fashion is a key consideration in health care. However, flexibility presents challenges for evaluating fidelity, which is much easier to evaluate when manualization and reproducible processes are possible. Hence, it remains unclear whether Open Dialogue and other need‐adapted mental health interventions can be meaningfully evaluated for fidelity. The aim of this paper was to critically appraise and advance the evaluation of fidelity in need‐adapted mental health care, using Open Dialogue as a case study. The paper opens a discussion about how fidelity should be evaluated in flexible, complex interventions, and identifies key questions that need to be asked by practitioners working in need‐adapted mental health care to ensure they deliver these interventions as intended and in an evidence‐based fashion. [ABSTRACT FROM AUTHOR]

Objective: To study the factors associated with the subsequent (over next 9 years) full-text publication of papers presented at the 44 National Conference of Indian Academy of Pediatrics (PEDICON), 2007. Methods: All papers presented at PEDICON 2007 were searched for subsequent full-text publication over the next 9 years in English-language journals by an internet-based search. The published papers were compared with the conference-abstracts. Results: 74 (16%) of the 450 abstracts presented were subsequently published; 61 (82.4%) in Medline-indexed journals. Majority (50, 67.6%) of the papers was published within the first 36 mo in journals with mean (SD) impact factor of 2.62 (1.63). The factors significantly associated with subsequent publication were papers presented as award papers ( P<0.001), those reporting on Interventional trials ( P<0.001), and those from medical colleges ( P<0.05). On comparison of the conference abstracts with the subsequently published full-papers, 55% had a change in title; authors were changed in 65%, and participants' numbers were dissimilar in 8.6%. Conclusions: There is a need to identify the factors responsible for this low rate of subsequent publication, and interventions to improve it both at institutional and researchers' level. [ABSTRACT FROM AUTHOR]